title: Non-Hodgkin lymphoma (NHL) in children with Nijmegen Breakage syndrome (NBS).
abstract: BACKGROUND
  Due to small number of patients with Nijmegen Breakage Syndrome (NBS) and Non-Hodgkin lymphoma (NHL) experience in their treatment is limited.
  
  
  METHODS
  Since 1996, 17 patients with a median age of 9.5 years who had NBS, were treated for NHL. NHL type, stage, chemotherapy, dose modifications, chemotherapy delays, response to chemotherapy, toxicity, outcome and correlation of drug reduction with response to treatment and outcome were analyzed.
  
  
  RESULTS
  Nine patients had TNHL, eight BNHL. TNHL patients received BFM and BNHL LMB type protocols. Doses of cytostatics were reduced in the first chemotherapy courses. Further modifications depended on severity of complications. None of the patients complied with timing of chemotherapy. Complete remissions after induction were achieved in 8 of 9 TNHL and 3 out 8 of BNHL patients. All patients experienced grade 4 toxicities. Two patients died from complications. Six of 17 patients are alive. All received more than 80% of recommended doses of chemotherapy. No differences in the type, number of responses or grade 3 and 4 toxicities between patients receiving less or more than 80% of drug doses were observed. Treatment related deaths concerned patients who received less than 80% of drug doses.
  
  
  CONCLUSIONS
  Patients with NBS develop both T and B cell lymphomas. Treatment outcome is poor and might be improved by administering over 80% of drug doses. Although toxicity often depends upon drug doses, our patients experienced equal grade 3 and 4 toxicities whether they received more or less than 80% of the chemotherapeutic agents.
authors.affiliation: Department of Pediatric Oncology, The Children's Memorial Health Institute, Warsaw, Poland. b.dembowska@czd.pl
authors.forename: Bozenna
authors.initials: B
authors.lastname: Dembowska-Baginska
authors.forename: Danuta
authors.initials: D
authors.lastname: Perek
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Brozyna
authors.forename: Anna
authors.initials: A
authors.lastname: Wakulinska
authors.forename: Dorota
authors.initials: D
authors.lastname: Olczak-Kowalczyk
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Gladkowska-Dura
authors.forename: Wieslawa
authors.initials: W
authors.lastname: Grajkowska
authors.forename: Krystyna H
authors.initials: KH
authors.lastname: Chrzanowska
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000633:toxicity; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D049932:Nijmegen Breakage Syndrome / Q000150:complications* / Q000188:drug therapy; D012074:Remission Induction; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult